Anesthesiology:胸神经阻滞用于隆胸手术:一项随机、双盲、双中心对照试验

2021-08-22 “ 罂粟花”公众号 “ 罂粟花”公众号

Part.01

Part.01

背景

胸神经阻滞已被提议用于乳腺癌手术期间和术后的镇痛,但在乳房美容手术中数据存在矛盾。该试验验证了在隆胸术后增加切口前胸神经阻滞优于单独的全身多模式镇痛方案。第二个假设是,在接下来的几天内,术后阿片类的消耗量将减少,并对两种结果产生长期影响。

Part.02

方法

73名在全身麻醉下接受美容隆胸手术的成年女性患者被随机分配接受胸神经阻滞与不进行阻滞。两组均接受标准护理,仅使用常规多模式镇痛,包括系统对乙酰氨基酚和非甾体抗炎药。主要观察指标的测量方法是在拔管后的前6小时的最大数值评分量表。次要观察指标包括术中瑞芬太尼用量和从拔管到第5天:最大数值评分量表、术后累积阿片类药物用量和术后阿片类药物副作用,以及第5天记录患者满意度。

Part.03

结果

与对照组相比,胸神经阻滞组在前6h的最大数值评分量表得分较低(3.9±2.5 vs.5.2±2.2);差异:–1.2[95%置信区间,–2.3至–0.1];P=0.036)。胸神经阻滞组在第1天至第5天之间的最大数值评分量表较低(2.2±1.9对3.2±1.7;P=0.032)。胸神经阻滞组从第6小时到第1天(0.0[0.0-21.0]vs.21.0[0.0-31.5]mg,P=0.006)和第1-5天(0.0[0.0-21.0]vs.21.0[0.0-51]mg,P=0.002)的阿片类药物总消耗量(口服吗啡当量)较低。

Part.04

结论

胸神经阻滞结合多模式镇痛,可有效缓解隆胸术后的围手术期疼痛,并可减少术后前5天的阿片类药物消耗。

原始出处:

Yassir Aarab, Severin Ramin, Thomas Odonnat,et al. Pectoral Nerve Blocks for Breast Augmentation Surgery: A Randomized, Double-blind, Dual-centered Controlled Trial. ANESTHESIOLOGY 2021; 135:442–53.

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    2022-08-06 amyloid
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    2021-08-24 xlxchina
  7. [GetPortalCommentsPageByObjectIdResponse(id=1705769, encodeId=d6e11e05769f0, content=<a href='/topic/show?id=aa6f984256a' target=_blank style='color:#2F92EE;'>#隆胸手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98425, encryptionId=aa6f984256a, topicName=隆胸手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8b431073750, createdName=yangfl16, createdTime=Wed Jun 22 06:30:36 CST 2022, time=2022-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775577, encodeId=a7e11e75577b2, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Sat Aug 06 08:30:36 CST 2022, time=2022-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051682, encodeId=5e2020516820e, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Apr 16 08:30:36 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1987306, encodeId=1ea7198e30626, content=<a href='/topic/show?id=bac5466546c' target=_blank style='color:#2F92EE;'>#对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46654, encryptionId=bac5466546c, topicName=对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Nov 25 07:30:36 CST 2021, time=2021-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396483, encodeId=5039139648399, content=<a href='/topic/show?id=77ec9842412' target=_blank style='color:#2F92EE;'>#隆胸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98424, encryptionId=77ec9842412, topicName=隆胸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573121, encodeId=10cb15e31217f, content=<a href='/topic/show?id=fef43e52220' target=_blank style='color:#2F92EE;'>#双盲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37522, encryptionId=fef43e52220, topicName=双盲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db3115807173, createdName=xlxchina, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588475, encodeId=aed415884e5de, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010435, encodeId=83a6101043521, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210119/bb0a9aa9368143bab03e27750bbbe97a/8e8df924fcde4cc79a8c1fd1c62a0256.jpg, createdBy=8b772187684, createdName=Aduo , createdTime=Sun Aug 22 23:22:52 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039053, encodeId=eaa41039053a0, content=高质量研究,读起来真爽,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sun Aug 22 13:30:36 CST 2021, time=2021-08-22, status=1, ipAttribution=)]
    2021-08-24 skhzy
  8. [GetPortalCommentsPageByObjectIdResponse(id=1705769, encodeId=d6e11e05769f0, content=<a href='/topic/show?id=aa6f984256a' target=_blank style='color:#2F92EE;'>#隆胸手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98425, encryptionId=aa6f984256a, topicName=隆胸手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8b431073750, createdName=yangfl16, createdTime=Wed Jun 22 06:30:36 CST 2022, time=2022-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775577, encodeId=a7e11e75577b2, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Sat Aug 06 08:30:36 CST 2022, time=2022-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051682, encodeId=5e2020516820e, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Apr 16 08:30:36 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1987306, encodeId=1ea7198e30626, content=<a href='/topic/show?id=bac5466546c' target=_blank style='color:#2F92EE;'>#对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46654, encryptionId=bac5466546c, topicName=对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Nov 25 07:30:36 CST 2021, time=2021-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396483, encodeId=5039139648399, content=<a href='/topic/show?id=77ec9842412' target=_blank style='color:#2F92EE;'>#隆胸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98424, encryptionId=77ec9842412, topicName=隆胸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1573121, encodeId=10cb15e31217f, content=<a href='/topic/show?id=fef43e52220' target=_blank style='color:#2F92EE;'>#双盲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37522, encryptionId=fef43e52220, topicName=双盲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db3115807173, createdName=xlxchina, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588475, encodeId=aed415884e5de, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Tue Aug 24 01:30:36 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010435, encodeId=83a6101043521, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210119/bb0a9aa9368143bab03e27750bbbe97a/8e8df924fcde4cc79a8c1fd1c62a0256.jpg, createdBy=8b772187684, createdName=Aduo , createdTime=Sun Aug 22 23:22:52 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1039053, encodeId=eaa41039053a0, content=高质量研究,读起来真爽,谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sun Aug 22 13:30:36 CST 2021, time=2021-08-22, status=1, ipAttribution=)]
    2021-08-22 Aduo

    学习学习

    0

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    2021-08-22 肿瘤克星

    高质量研究,读起来真爽,谢谢梅斯

    0

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